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Breastfeeding 1/2 to 2/3 of waking time

Hi,
since the tube weaning (more on our situation here: http://forums.llli.org/showthread.ph...ding-24-weeker) my DS (14m/10m corrected) is exclusively breastfed. He lost a lot of weight (8,8kg - 7,7kg) during the weaning, especially since he had a bad cold (no appetite) right after taking out the tube and since we thought he would eat solids by then, the doctor thought to prevent me from getting mastitis and told me to stop pumping. So by the end of the weaning process and after the cold there seemed to be not enough milk anymore. For one week he virtually drank all day with no break at all, he always wanted to be at the breast and during nights I pumped to get back the milk. After one week it came back so that his weight jumped back to 7,9kg an I got plugged ducts. After this he settled at around 7,7kg and kept this weight ever since the mid of October. Plus mainly because of his VP-shunt his head circumference is not growing since July to some extend it might as well have been worsened by the weight loss. So he knows when he is hungry and can show it plus he is not hungry all day.

But he also drinks now maybe 1/2 to 2/3 of his waking time (and 1 to 3 times during night). I thought he would get "better" after some weeks and make longer breaks between meals. His meals are maybe a tiny bit shorter now.

And so this is our problem, what is wrong here or is this still completely normal? Do you have any idea how to safely extend the breaks? Of course I would love to have time maybe for a walk with him (and still we are having a lot of medical appointments every week, six or more).

I don't feel this is a question of low supply although he does not gain weight (he still is not far as skinny as most micro preemies we know 7,7kg at 68cm), since he also sometimes shows no hunger signs and refuses the breast, he has enough wet diapers (at least six plastic diapers per day, poops about once in two days to two times a day), is very happy and lively and develops well and whenever I try to express some milk, there is milk coming. But maybe it nevertheless is a question of supply? Maybe the milk is coming too slow?

He keeps a (to me) strong vacuum, but his drinking is strange I have nothing to compare with, except the videos at http://www.nbci.ca where I see a suck-swallow ratio of 1:1). At times (especially at night) he can suck-swallow 1:1, at day he often sucks way more often (maybe 10:1) or sucks with no swallowing at all in several minutes.

We keep offering him solids but I think it still will take maybe weeks to months till he really eats solids, so I concentrate on improving the breastfeeding here.

To sum it up: Of course I would most love if he started to gain weight now, but my heart says, maybe this is still okay the way it is seeing that his head cannot grow, his body hardly grows and that he keeps a reasonable BMI. So if you have any idea, how I can help him gain weight, I would like to hear it. My main question for this thread is his drinking performance: The suck-swallow ratio and the long and often meals. Is it normal? If not, how can we safely improve it? (We are living in Europe and as far as I know we have no professional LCs around our area.)

Re: Breastfeeding 1/2 to 2/3 of waking t

Ok, so you're concerned about the nursing... it sounds like he is possibly comfort nursing some of the time rather than full out nursing? I'm a bit out of my zone so far as my own experience, but I think I remember hearing that offering the other breast could help (i.e. the milk has slowed from first side, he's starting to comfort nurse -- you could offer the other side, which will letdown and maybe get him nursing more intently again).

fwiw, if you wear your LO in a wrap or carrier, you could take a walk while he nurses!

3/2011 {EBF to 6mos, now BF and BLS, CD, EC'ing since 5mos - in underwear at 11mos, and babywearing} Babywearing International has chapters - see if there's one near you... most have lending libraries!

Re: Breastfeeding 1/2 to 2/3 of waking t

Hi elisabetsey,
thanks for your answer. Yes I thought about whether this is "comfort nursing" as well and that I am maybe offering the breast too often. On the other hand he shows his hunger signs quite often and quite often takes the breast when offered. But he rarely provokes a "full" let-down, so he is drinking with a better suck-swallow-ratio maybe for a minute or not at all from the start on. Does this sound okay, one minute let down and then changing sides? I will try this. One problem I see is that when I "forcefully" take him from the breast after he is slowing down, he usually won't accept to latch again. But maybe this is okay, for if he still was hungry, he would latch? What do you think?

Re: Breastfeeding 1/2 to 2/3 of waking t

I don't know if my experience helps, as every baby is different of course. But my baby for the most part doesn't do a 1:1 suck ratio. I actually remember the 1:1 only from when I had oversupply and overactive letdown in the first few months, and not again. I never counted the suck/swallows to have a precise measurement, but I know that she sucks several times before a swallow. I don't have supply issues (actually at 9 months I still have a bit of an oversupply) and she's always gained well. What I'm trying to say is that the suck/swallow ratio might not be the only or best indicator of how much your baby is taking.

Also, I wouldn't switch breasts after only one minute. I'd let baby suck to his heart's content on one breast, and then offer the other one "as dessert" as my LC once said.

Re: Breastfeeding 1/2 to 2/3 of waking t

Also, I wouldn't switch breasts after only one minute. I'd let baby suck to his heart's content on one breast, and then offer the other one "as dessert" as my LC once said.

That's a good way to put it . I also like the breast compression suggestion!

If you are really concerned with how much he is taking during a feeding, you can weigh him on a medical grade scale before ...and after ...one nursing session.

3/2011 {EBF to 6mos, now BF and BLS, CD, EC'ing since 5mos - in underwear at 11mos, and babywearing} Babywearing International has chapters - see if there's one near you... most have lending libraries!

Re: Breastfeeding 1/2 to 2/3 of waking t

El.ro,
I cant speak to why he isnt gaining weight, but nursing all the time is not necessarily unusual, especially If he's dealing with pain. I read your other post, and mostly i want to express my admiration for you. You have done an amazing job caring for your son -- I think it's really remarkable that you got him to breastfeed! Everything was working against you, but you persisted. Big hugs to you as you figure out the details of your post-tube world.

Kate

Mother to a sweet boy, born at 34 weeks on 2/11/11.
Proud that I grew 26 lbs of baby before solids, and still counting...

Re: Breastfeeding 1/2 to 2/3 of waking t

Hi,
thanks for your advices again

kmanih, that's quite important news to me, that your daughter does not do a "1:1" as well. I am really interested in learning how other babies behave like.

So, I tried to change sides not after one minute, but when there was hardly any more swallowing between sucking and he then usually refused the other side. Breast compression helps somewhat to activate him again.

We gave up weighing him, since we felt we did not get accurate measurements and it just made us unnecessarily desperate. During the tube weaning we weighed him once a day, counted diapers and watched for signs of dehydration.

Reading your posts, I feel again that maybe everything really is not as wrong as other people make us think (most of the time it does not feel so wrong to me) and I should rather try to arrange everything around those frequent nursings, than trying to reach less frequent nursings.